Residual loose skin under chin after Platysmaplasty with incisions under chin and behind the ears. (photo)

Question

On 1/2/14 I had a corset platysmaplasty. 3 months later, my ps pulled behind my ears in an attempt to tighten residual loose skin as well as address the deeper muscles. Unfortunately, my platysma bands became unattached and reappeared along with loose skin beneath my chin. 3 wks ago, my doctor performed a revision through the incision beneath my chin. My neck skin below my chin is now looser and has more irregularities than ever before. I am in my early 40's. What do you advise for tightening the skin?

Farhad Rafizadeh, MD · Answer

Sorry to see your frustration. Unfortunately you need yet another procedure. The platisma bands need to be interrupted and repaired together. You might also need another skin lift. You obviously need to be examined as the pictures are not sufficient to make the complete evaluation and give you the best answer.

Larry S. Nichter, MD, MS, FACS · Answer

Unfortunately an exam is needed for the best advice along with viewing your preoperative photos. However from the photos you provided  it would appear that your main problem is residual platysmal bands. If this is the case than these rather than skin tightening should be addressed. You may wish to get a second opinion from a board certified plastic surgeon.

Jose Perez-Gurri, MD, FACS · Answer

Hi and thanks for your question. You need to have a facelift to include work on the SMAS. You may have been reluctant because of added incisions however, looks at how many procedures you have now undergone. That excess skin below your neck will not improve with a limited skin lifting or a corset platysmaplasty. Speak to your surgeon but I would suggest that you get a second opinion. Good luck

Ali Totonchi, MD · Answer

It seems like that you had few surgeries in short period of time, before any kind of revision I would recommend to wait up 6 months and let the scat tissue to settle down before doing any revisions, if needed.

Robert M. Freund, MD · Answer

It does not look from the limited photos that you have excess skin. It seems the the platysmal bands has created the appearance of excess skin. Also, from the photos shown, there is no way to determine if you need anything more than a better treatment of the platysma muscle. So discussion of facelifts is not relevant to this discussion.I agree with one of the other doctors, who suggests waiting a little while for the scarring to settle down. If nothing changes, then consider a revision to the platysma, with a lengthening and tightening procedure. if this is done properly, then the bands will resolve and the angle will be re-established. The skin will then look tight, as well.

Residual loose skin under chin after Platysmaplasty with incisions under chin and behind the ears. (photo)

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